Does Timing of Presentation of Penile Fracture Affect Outcome of Surgical Intervention?

El‐Assmy, Ahmed; El-Tholoth, Hossam S.; Mohsen, Tarek; Ibrahiem, El Housseiny I.

doi:10.1016/j.urology.2010.12.070

Cited by 44 publications

(44 citation statements)

References 19 publications

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“…Kozacioglu and colleagues [23], reported no serious deformity or ED as a consequence of delay in surgery within a given time frame in 56 penile fractures, in terms of number of hours to presentation (mean number of hours from trauma to repair 11.3 ± 8.5 hours). Similarly , el-Assmy and colleagues [24], noted no difference in serious long-term complications between those who were treated surgically following an early (within 24 hours) or delayed (up to 7 days) presentation. Of their cohort, 17% presented as delayed fractures.…”

Section: Discussionmentioning

confidence: 90%

Long Term Outcome of Patients with Penile Fracture Undergoing Delayed Repair

Rajendra¹,

Vikas²,

Amit³

et al. 2017

Open J Trauma

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Introduction: Fracture of the penis is a rare urological emergency which occurs as a result of abrupt trauma to an erect penis. Immediate surgical repair is the standard of care and is superior to nonoperative management due to excellent long term outcomes. A large percentage of the patients present late for treatment out of fear or embarrassment. We report our series of patients who presented late and underwent delayed repair. We also report the long term outcome in these patients. Materials & Methods:The data was retrospectively collected from hospital records, which included: detailed history, symptoms, type of relationship, mechanism of trauma, sexual position, clinical fi ndings at physical examination, imaging results, presence of urethral injury, outcomes, and long-term complications regarding sexual and voiding functions.Results: Twenty two patients presented to our hospital casualty/emergency services following penile fracture and underwent delayed surgical repair. Heterosexual inter-course was the most common cause of fracture (18 patients, 81.81%). The mean time duration between injury and presentation was 48.77±33.56 hours. The mean time duration between presentation and surgical intervention was 4.31±1.37 hours. MRI was done in 6 cases with positive predictive value of 100%. Seventeen (77.27%) patients experienced erections during the post-operative period in the hospital. At the end of 1 year follow-up all the 22 patients had been having sexual intercourse.Conclusions: Our data suggests that, patients with penile fractures undergoing delayed repair have preservation of erectile potency and overall sexual function is maintained.

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Section: Discussionmentioning

confidence: 90%

Long Term Outcome of Patients with Penile Fracture Undergoing Delayed Repair

Rajendra¹,

Vikas²,

Amit³

et al. 2017

Open J Trauma

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“…This practice has not optimum outcome [7]. However there are recent large studies with long-term follow-up which show that repair up to a week later produce equally good results [8].…”

Section: Acute Pain and Swelling Of The Penis Is Known As Acutementioning

confidence: 99%

A case of penile fracture caused by self manipulation to achieve detumescence

2014

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A 47-year old man was admitted to the surgical emergency close to midnight with a painful swelling of his penis. He had been practicing self manipulation of the erect penis to achieve a rapid detumescence from early morning erections regularly for many years. He had forcibly bent the penis at mid shaft level on that particular morning. There had been a cracking sound and he experienced pain with gradual swelling of the penile shaft. Neither voiding difficulties nor haematuria was observed. Wet ice packs had been placed on the shaft to control the swelling and diclofenac sodium tablets were taken to control the pain. After 17 hours he admitted to the hospital as the swelling got worse and pain became severe despite analgesics.Physical examination revealed a tender and swollen penis. We could not palpate a defect in the corpora/ shaft of the penis due to swelling and tenderness. A clinical diagnosis of acute penis due to penile fracture was made and consent was taken to explore the penis.A circum-coronal incision was made after applying a tourniquet at the root of the penis, under general anaesthesia. The penis was degloved to expose the corpora cavernosa. There was a haematoma deep to the Buck's fascia over the proximal part of the right corpus cavernosum near the root of the penis (Figure 1).Evacuation of the blood clot revealed a rupture of the right corpus with a defect confirming the presumptive diagnosis of a penile fracture (Figure 2). The contused and irregular fascial edge was trimmed. The defect was repaired using 4/0 polyglactin sutures in two layers.There was no damage to the left corpus cavernosum.The corpus spongiosum with the urethra was intact. A circumcision was done and a urethral catheter was kept in situ for five days. Intravenous co-amoxiclav was given to avoid sepsis with oral non-steroidal analgesics for pain control.The patient was experiencing good erections without pain or angulation when reviewed three weeks after surgery and had been so for the last two years.

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“…Interestingly enough, another study found that early surgical intervention (1-24 hours vs. 30 hours-7 days) may not reduce the complication rate related to this injury. 10 Conservative treatment, including ice packs, anti-inflammatory medications, supportive dressings, anti-erection drugs, and antibiotics, yields a lower success rate in regards to erectile dysfunction of 20-59% as compared to 89.2-96% for surgical intervention. Conservative treatment leads to significantly worse outcomes, including significant degrees of erectile dysfunction and penile curvature as well as a much longer mean hospital stay of 14 days vs. 3.8 for surgically managed patients.…”

mentioning

confidence: 99%

Case of Penile Fracture Revealing Bilateral Corporal Cavernosal Tears and Complete Urethral Disruption

Radadia¹,

Saifuddin²,

Farber³

et al. 2017

IJCRR

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Abstract:Penile fracture is a rare urological injury sustained most commonly during sexual intercourse. While an associated urethral injury is not uncommon, complete urethral disruption is very rare. We report the case of a 46 year old man who presented with acute penile pain and swelling status post blunt trauma sustained during sexual intercourse. Emergency surgery revealed large bilateral corporal tears and complete urethral disruption, all of which were surgically repaired. Postoperatively, the patient demonstrated excellent recovery with normal voiding function and satisfactory erections. This case emphasizes the importance of early surgical exploration and repair of penile fractures.

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Does Timing of Presentation of Penile Fracture Affect Outcome of Surgical Intervention?

Cited by 44 publications

References 19 publications

Long Term Outcome of Patients with Penile Fracture Undergoing Delayed Repair

Long Term Outcome of Patients with Penile Fracture Undergoing Delayed Repair

A case of penile fracture caused by self manipulation to achieve detumescence

Case of Penile Fracture Revealing Bilateral Corporal Cavernosal Tears and Complete Urethral Disruption

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